The present invention relates generally to healthcare monitoring systems and methods and, more particularly, to a system and method for dispensing and monitoring medication for healthcare treatment.
A 1995 American Association of Retired Persons study reported that Americans age 65 and older are taking an average of 2.4 prescription drugs, while those age 50-64 take an average of 1.7 prescription drugs. It is also reported that 40% of those failed to follow their physician's dosage instructions. The Healthcare Compliance Package Council states that of the 1.8 billion prescriptions per year dispensed in the U.S., 50% are not correctly taken. The article that discussed this topic was featured in the September 1998 edition of the Packaging Digest Magazine. From the same source it is also reported that more than 80% of the current 36.3 million people over age 65 in the United States, a number that is sure to increase, are on some type of prescription medication-taking regimen. According to the National Medical Expenditure Survey, in 1987, 90 million Americans suffered from one or more chronic conditions. Treatment of these chronic conditions represents over 76% of healthcare expenditures, and the total direct cost of treating these chronic conditions is estimated to rise to $798 billion in 2030.
These statistics clearly depict the usefulness of a system to help patients comply with their medication-taking regimen while limiting their risk of potential adverse complications. As a result of compliance, the patient is in a better position to control their treatment recovery time. Remembering to accurately take medication on time and correctly is well understood to be a very serious health problem, particularly for the elderly and patients with chronic conditions for whom the intake of many different drugs is common. Failure to comply with medication-taking regimens is associated with deterioration of health status, as well as an increase in preventable fatalities. The annual cost related to non-compliance with medication-taking regimens was estimated to be in excess of $100 billion in 1998.
The drop off rate for refilling medications for chronic diseases is very high, with up to 75% of monthly prescriptions not refilled after one year. Forgetfulness to self-administer the prescribed medication at the correct intervals and correct dosages by the patients has long been found to be a major hurdle for doctors in determining the effectiveness of prescriptions. It is also well known that the more frequently a medication must be taken, the more likely the patient's compliance rate will drop. For patients who must take three, four or even five dosages of several medications daily, the prescribed regimen can easily become confusing. Many patients resort to carrying daily timetables—pill containers that sort out the medication by day of the week, or they even rely on somebody else to tell them when to take their medication. This can be effective but does not eliminate the possibility of the patient becoming distracted or simply forgetful in addition to the lack of a reliable compliance record.
Various devices for assisting patients in following medication-taking regimens are known. For example, U.S. Pat. No. 6,294,999 to Yarin et al. describes a smart tray with a plurality of medication containers equipped with electromagnetic tags that provides various information about medication contained within a respective container. The smart tray is equipped with a processor and reader that interrogates each respective electromagnetic tag to identify medication contained within each container. Using the retrieved information, a smart tray provides visual and/or audio signals to a patient to remind the patient when and how much of various medicaments to take. The device can also communicate with one or more third parties, such as healthcare providers, pharmacies, and other suppliers of healthcare products and services via a computer network. In addition, a smart tray can communicate with various appliances and can modify medication regimens for particular situations in response to data received from various appliances.
U.S. Pat. No. 5,020,037 to Raven discloses an alarm pillbox which cancels the alarm when a compartment lid is opened. A visual display is used to indicate the number of times that the lid has been opened within one day.
U.S. Pat. No. 5,408,443 to Weinberger describes a medication-dispensing system that includes a prescribing data entry station for use by a physician to store prescription information in a portable prescribing module, a dispensing data entry station for use by a pharmacy to store dispensing information in a portable dispensing data storage unit, and a medication dispenser responsive to information stored in the portable prescribing module to describe use of medication in the dispenser in accordance with a regimen prescribed by the physician and to the dispensing data storage unit to control dispensing of the medication. One embodiment has two medication drawers each having a plurality of compartments with indicating lights selectively indicating the compartment from which medication is to be taken, a screen for displaying instructions regarding loading of the medication compartments and taking of the medication, and a keyboard for confirming compliance with the instructions. Another embodiment has a series of medication-containing compartments, each covered by a separate sliding or folding cover.
U.S. Pat. No. 4,911,327 to Shepherd et al., describes a dispenser for providing scheduled dosages of pills according to a predetermined medication program. A housing contains a plurality of pill containers from which dosages of pills may be released into a user-accessible pill receiver. The release of pills is controlled such that pills are released at predetermined intervals as dictated by the medication program. On release of a dosage of pills, an alarm is activated to indicate to a user that a dosage is due to be taken, the alarm being deactivated when the user accesses the pill receiver to remove the dosage of pills. If the user does not access the pill receiver within a predetermined time interval from release of the dosage, an optional remote alarm may be activated to alert a supervisor.
U.S. Pat. No. 5,239,491 to Mucciacciaro describes a holder having a plurality of recesses for holding a plurality of medication containers, each fitting into a unique recess. The geometry of the bottom of each medication container is unique and only matches one recess in the holder. A sensor in each recess signals the presence or absence of the dedicated container to a microprocessor. The microprocessor is programmed with the prescribed dose administration schedule for each of the different medications in the different containers. A real time clock cooperates with the microprocessor and the program to signal audibly and visibly by a light in the appropriate container when a particular pill should be administered. The signals stop when the appropriate container is removed from its recess. A different warning sound indicates when the wrong container is lifted.
U.S. Pat. No. 4,837,719 to McIntosh describes a medication clock for signaling the times that dosages of a medication should be taken. The McIntosh device also provides a record of when each medication was taken for comparison with the medication schedule. In addition, the McIntosh device can monitor and record temperature, blood pressure and pulse rate of the user.
U.S. Pat. No. 4,616,316 to Hanpeter et al. describes a medication compliance monitoring system consisting of a blister pack having an array of plastic blisters defining compartments for medication. The blister pack has a frangible non-conductive backing sheet including conductive traces behind the compartments, which are respectively ruptured when the medication doses are removed. An electronic memory circuit detects when individual compartments are ruptured and stores this information.
E-pill (www.epill.com) offers a pager system that sends reminders to patients to take their medication at a specific time of the day. Carebridge (www.carebridge.net) provides an electronic timing device that patients can use to help them remember to take their medication.
IBV Technologies (Seattle, Wash.) provides a medication vial that records the time a patient takes his/her medication when a button is pressed by the patient. When returned to a pharmacy for a refill, the pharmacist can download and review a compliance report from the vial and counsel the patient regarding medication compliance.
APREX (Union City, Calif.) provides a telemedline service for monitoring medication compliance. Patients take their medication from medication containers outfitted with caps that have a microcomputer therein. When patients remove the cap from a bottle to take a dose of the medication contained therein, the microcomputer records the time and date of the dosing event. At the end of the day, patients place their medication bottles on a specially configured modem that transmits daily dosing information to a selected healthcare provider. If the healthcare provider detects a problem in how or when patients are taking their medication, specially trained healthcare providers call those patients the next day.
The MediMonitor, available from InforMedix, Inc. (Rockville Md.), is configured to retain a month supply of up to five medications in individual compartments and alerts patients when and how to take the medications. The MediMonitor also monitors medication use and health status by providing a date and time-stamped record of a patient's medication-taking behavior together with patient responses to specific questions. MediMonitor can transmit information via an internet-accessible server and database to clinical drug trial sites, physicians, pharmacies and other healthcare providers. Healthcare providers can communicate information, as well as reminders and specific instructions, directly to patients via the MediMonitor.
Unfortunately, existing devices for assisting patients in following medication-taking regimens can be somewhat non-accessible to the public due to price and difficult to use because of their complexity. Furthermore, existing devices for assisting patients in following medication-taking regimens can seem somewhat intrusive to a user.